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STATE ID NUMBER 00000018700001 <br /> '��c APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> `:' .O1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> ROYS ELECTRIC ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 7855 BATES ROAD TRACY CA 95376 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> ROYS ELECTRIC <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 7855 BATES ROAD <br /> CITY COUNTY <br /> ZIP <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDRESS CITY STATE Zip <br /> 7855 BATES ROAD TRACY CA 95376 <br /> PHONE W/APIA CODE TYPE OF BUSINESS <br /> 209-835-668 ( ) 01 GASOLINE STATION (X) 02 OTHER <br /> NUMSEP OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: N4ME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> COLE ROY 209-835-668j$- SAME �D p% —2 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1981 C. YEAR INSTALLED 1981 ( 7 UNKNOWN <br /> 0. CONTAINER CAPACITY: 1000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (X) 01 UNLEADED ( 1 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON—VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( l 03 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL f 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( l 05 CONCRETE <br /> f ) 06 ALUMINUM ( 1 07 STEEL CLAD ( 108-BRONZE ( ) 09 COMPOSITE ( ) 10 NON—METALLIC <br /> [ 1 12 UNKNOWN ( ) 13 OTHER: <br /> MSC04-070185 (10/18/85) PAGE 1 <br /> ,m <br />